Genetics and early environment, as well as psychological
and social processes, appear to be important contributory factors. Some
recreational and prescription drugs appear to cause or worsen symptoms.
The many possible combinations of symptoms have triggered debate about
whether the diagnosis represents a single disorder or a number of
separate syndromes. Despite the origin of the term from the Greek roots skhizein ("to split") and phrēn ("mind"), schizophrenia does not imply a "split personality", or "multiple personality disorder"—a condition with which it is often confused in public perception.[1] Rather, the term means a "splitting of mental functions", reflecting the presentation of the illness.[2]

The mainstay of treatment is antipsychotic medication, which primarily suppresses dopaminereceptor activity. Counseling,
job training and social rehabilitation are also important in treatment.
In more serious cases—where there is risk to self or others—involuntary hospitalization may be necessary, although hospital stays are now shorter and less frequent than they once were.[3]

Symptoms begin typically in young adulthood, and about 0.3–0.7% of people are affected during their lifetime.[4] The disorder is thought to mainly affect the ability to think,
but it also usually contributes to chronic problems with behavior and
emotion. People with schizophrenia are likely to have additional
conditions, including major depression and anxiety disorders; the lifetime occurrence of substance use disorder is almost 50%.[5] Social problems, such as long-term unemployment, poverty, and homelessness are common. The average life expectancy
of people with the disorder is 12 to 15 years less than those without.
This is the result of increased physical health problems and a higher suicide rate (about 5%).[4][6]

Symptoms

Self-portrait
of a person with schizophrenia, representing that individual's
perception of the distorted experience of reality in the disorder

Individuals with schizophrenia may experience hallucinations (most reported are hearing voices), delusions (often bizarre or persecutory in nature), and disorganized thinking and speech.
The last may range from loss of train of thought, to sentences only
loosely connected in meaning, to speech that is not understandable known
as word salad
in severe cases. Social withdrawal, sloppiness of dress and hygiene,
and loss of motivation and judgment are all common in schizophrenia.[7] There is often an observable pattern of emotional difficulty, for example lack of responsiveness.[8] Impairment in social cognition is associated with schizophrenia,[9] as are symptoms of paranoia. Social isolation commonly occurs.[10] Difficulties in working and long-term memory, attention, executive functioning, and speed of processing also commonly occur.[4]
In one uncommon subtype, the person may be largely mute, remain
motionless in bizarre postures, or exhibit purposeless agitation, all
signs of catatonia.[11] About 30 to 50% of people with schizophrenia fail to accept that they have an illness or their recommended treatment.[12] Treatment may have some effect on insight.[13] People with schizophrenia often find facial emotion perception to be difficult.[14]

Positive and negative

Schizophrenia is often described in terms of positive and negative (or deficit) symptoms.[15]
Positive symptoms are those that most individuals do not normally
experience but are present in people with schizophrenia. They can
include delusions, disordered thoughts and speech, and tactile, auditory, visual, olfactory and gustatory hallucinations, typically regarded as manifestations of psychosis.[16] Hallucinations are also typically related to the content of the delusional theme.[17] Positive symptoms generally respond well to medication.[17]

Onset

Late adolescence and early adulthood are peak periods for the onset of schizophrenia,[4] critical years in a young adult's social and vocational development.[20] In 40% of men and 23% of women diagnosed with schizophrenia, the condition manifested itself before the age of 19.[21]
To minimize the developmental disruption associated with schizophrenia,
much work has recently been done to identify and treat the prodromal (pre-onset) phase of the illness, which has been detected up to 30 months before the onset of symptoms.[20] Those who go on to develop schizophrenia may experience transient or self-limiting psychotic symptoms[22] and the non-specific symptoms of social withdrawal, irritability, dysphoria,[23] and clumsiness[24] during the prodromal phase.

Causes

A combination of genetic and environmental factors play a role in the development of schizophrenia.[4][1]
People with a family history of schizophrenia who have a transient
psychosis have a 20–40% chance of being diagnosed one year later.[25]

Genetic

Estimates of heritability vary because of the difficulty in separating the effects of genetics and the environment;[26] averages of 0.80 have been given.[27] The greatest risk for developing schizophrenia is having a first-degree relative with the disease (risk is 6.5%); more than 40% of monozygotic twins of those with schizophrenia are also affected.[1] If one parent is affected the risk is about 13% and if both are affected the risk is nearly 50%.[27]

Assuming a hereditary basis, one question from evolutionary psychology is why genes that increase the likelihood of psychosis evolved, assuming the condition would have been maladaptive from an evolutionary point of view. One idea is that genes are involved in the evolution of language and human nature, but to date such ideas remain little more than hypothetical in nature.[32][33]

Environment

Environmental factors associated with the development of
schizophrenia include the living environment, drug use and prenatal
stressors.[4]
Parenting style seems to have no major effect, although people with
supportive parents do better than those with critical or hostile
parents.[1]
Childhood trauma, separation from ones families, and being bullied or abused increase the risk of psychosis.[34]
Living in an urban environment during childhood or as an adult has
consistently been found to increase the risk of schizophrenia by a
factor of two,[4][1] even after taking into account drug use, ethnic group, and size of social group.[35] Other factors that play an important role include social isolation
and immigration related to social adversity, racial discrimination,
family dysfunction, unemployment, and poor housing conditions.[1][36]

Substance use

About half of those with schizophrenia use drugs or alcohol excessively.[37] Amphetamine, cocaine, and to a lesser extent alcohol, can result in psychosis that presents very similarly to schizophrenia.[1][38] Although it is not generally believed to be a cause of the illness, people with schizophrenia use nicotine at much greater rates than the general population.[39]

Alcohol abuse can occasionally cause the development of a chronic substance-induced psychotic disorder via a kindling mechanism.[40] Alcohol use is not associated with an earlier onset of psychosis.[41]

A significant proportion of people with schizophrenia use cannabis to help cope with its symptoms.[37] Cannabis can be a contributory factor in schizophrenia,[42][43][44] but cannot cause it alone;[44] its use is neither necessary nor sufficient for development of any form of psychosis.[44] Early exposure of the developing brain to cannabis increases the risk of schizophrenia,[42] although the size of the increased risk is difficult to quantify;[42][43] only a small proportion of early cannabis recreational users go on to develop any schizoaffective disorder in adult life,[43] and the increased risk may require the presence of certain genes within an individual[44] or may be related to preexisting psychopathology.[42] Higher dosage and greater frequency of use are indicators of increased risk of chronic psychoses.[43]Tetrahydrocannabinol (THC) and cannabidiol (CBD) produce opposing effects; CBD has antipsychotic and neuroprotective properties and counteracts negative effects of THC.[43]

Other drugs may be used only as coping mechanisms by individuals who
have schizophrenia to deal with depression, anxiety, boredom, and
loneliness.[37][45]

Developmental factors

Factors such as hypoxia and infection, or stress and malnutrition in the mother during fetal development, may result in a slight increase in the risk of schizophrenia later in life.[4] People diagnosed with schizophrenia are more likely to have been born in winter or spring (at least in the northern hemisphere), which may be a result of increased rates of viral exposures in utero.[1] The increased risk is about 5 to 8%.[46]

Mechanisms

A number of attempts have been made to explain the link between altered brain function and schizophrenia.[4] One of the most common is the dopamine hypothesis, which attributes psychosis to the mind's faulty interpretation of the misfiring of dopaminergic neurons.[4]

Psychological

Many psychological mechanisms have been implicated in the development and maintenance of schizophrenia. Cognitive biases have been identified in those with the diagnosis or those at risk, especially when under stress or in confusing situations.[47] Some cognitive features may reflect global neurocognitive deficits such as memory loss, while others may be related to particular issues and experiences.[48][49]

Despite a demonstrated appearance of blunted effect, recent findings
indicate that many individuals diagnosed with schizophrenia are
emotionally responsive, particularly to stressful or negative stimuli,
and that such sensitivity may cause vulnerability to symptoms or to the
disorder.[50][51]
Some evidence suggests that the content of delusional beliefs and
psychotic experiences can reflect emotional causes of the disorder, and
that how a person interprets such experiences can influence
symptomatology.[52][53][54] The use of "safety behaviors" to avoid imagined threats may contribute to the chronicity of delusions.[55] Further evidence for the role of psychological mechanisms comes from the effects of psychotherapies on symptoms of schizophrenia.[56]

Neurological

Functional magnetic resonance imaging (fMRI) and other brain imaging
technologies allow for the study of differences in brain activity in
people diagnosed with schizophrenia. The image shows two levels of the
brain, with areas that were more active in healthy controls than in
schizophrenia patients shown in orange, during an fMRI study of working
memory.

Schizophrenia is associated with subtle differences in brain
structures, found in 40 to 50% of cases, and in brain chemistry during
acute psychotic states.[4] Studies using neuropsychological tests and brain imaging technologies such as fMRI and PET to examine functional differences in brain activity have shown that differences seem to most commonly occur in the frontal lobes, hippocampus and temporal lobes.[57] Reductions in brain volume, smaller than those found in Alzheimer's disease,
have been reported in areas of the frontal cortex and temporal lobes.
It is uncertain whether these volumetric changes are progressive or
preexist prior to the onset of the disease.[24] These differences have been linked to the neurocognitive deficits often associated with schizophrenia.[58]
Because neural circuits are altered, it has alternatively been
suggested that schizophrenia should be thought of as a collection of
neurodevelopmental disorders.[59] There has been debate on whether treatment with antipsychotics can itself cause reduction of brain volume.[60]

Particular attention has been paid to the function of dopamine in the mesolimbic pathway of the brain. This focus largely resulted from the accidental finding that phenothiazine
drugs, which block dopamine function, could reduce psychotic symptoms.
It is also supported by the fact that amphetamines, which trigger the
release of dopamine, may exacerbate the psychotic symptoms in
schizophrenia.[61] The influential dopamine hypothesis of schizophrenia proposed that excessive activation of D2 receptors was the cause of (the positive symptoms of) schizophrenia. Although postulated for about 20 years based on the D2 blockade effect common to all antipsychotics, it was not until the mid-1990s that PET and SPET
imaging studies provided supporting evidence. The dopamine hypothesis
is now thought to be simplistic, partly because newer antipsychotic
medication (atypical antipsychotic medication) can be just as effective as older medication (typical antipsychotic medication), but also affects serotonin function and may have slightly less of a dopamine blocking effect.[62]

Interest has also focused on the neurotransmitter glutamate and the reduced function of the NMDA glutamate receptor in schizophrenia, largely because of the abnormally low levels of glutamate receptors found in the postmortem brains of those diagnosed with schizophrenia,[63] and the discovery that glutamate-blocking drugs such as phencyclidine and ketamine can mimic the symptoms and cognitive problems associated with the condition.[64]
Reduced glutamate function is linked to poor performance on tests
requiring frontal lobe and hippocampal function, and glutamate can
affect dopamine function, both of which have been implicated in
schizophrenia, have suggested an important mediating (and possibly
causal) role of glutamate pathways in the condition.[65] But positive symptoms fail to respond to glutamatergic medication.[66]

Criteria

In 2013, the American Psychiatric Association released the fifth edition of the DSM (DSM-5).
To be diagnosed with schizophrenia, two diagnostic criteria have to be
met over much of the time of a period of at least one month, with a
significant impact on social or occupational functioning for at least
six months. The person had to be suffering from delusions,
hallucinations or disorganized speech. A second symptom could be
negative symptoms or severely disorganized or catatonic behaviour.[68]
The definition of schizophrenia remained essentially the same as that
specified by the 2000 version of DSM (DSM-IV-TR), but DSM-5 makes a
number of changes.

Subtype classifications – such as catatonic and paranoid schizophrenia
– are removed. These were retained in previous revisions largely for
reasons of tradition, but had subsequently proved to be of little worth.[69]

In describing a person's schizophrenia, it is recommended that a
better distinction be made between the current state of the condition
and its historical progress, to achieve a clearer overall
characterization.[69]

An assessment covering eight domains of psychopathology – such as whether hallucination or mania is experienced – is recommended to help clinical decision-making.[71]

The ICD-10 criteria are typically used in European countries, while
the DSM criteria are used in the United States and to varying degrees
around the world, and are prevailing in research studies. The ICD-10
criteria put more emphasis on Schneiderian first-rank symptoms. In
practice, agreement between the two systems is high.[72]

Subtypes

The DSM-5 work group proposed dropping the five sub-classifications of schizophrenia included in DSM-IV-TR:[73][74]

Paranoid type:
Delusions or auditory hallucinations are present, but thought disorder,
disorganized behavior, or affective flattening are not. Delusions are
persecutory and/or grandiose, but in addition to these, other themes
such as jealousy, religiosity, or somatization may also be present. (DSM code 295.3/ICD code F20.0)

Prevention

Prevention of schizophrenia is difficult as there are no reliable markers for the later development of the disease.[80] The evidence for the effectiveness of early interventions to prevent schizophrenia is inconclusive.[81] While there is some evidence that early intervention in those with a psychotic episode may improve short-term outcomes, there is little benefit from these measures after five years.[4] Attempting to prevent schizophrenia in the prodrome phase is of uncertain benefit and therefore as of 2009 is not recommended.[82]Cognitive behavioral therapy may reduce the risk of psychosis in those at high risk after a year[83] and is recommended by the National Institute for Health and Care Excellence (NICE) in this group.[84] Another preventative measure is to avoid drugs that have been associated with development of the disorder, including cannabis, cocaine, and amphetamines.[1]

Management

The primary treatment of schizophrenia is antipsychotic medications,
often in combination with psychological and social supports.[4] Hospitalization may occur for severe episodes either voluntarily or (if mental health legislation allows it) involuntarily. Long-term hospitalization is uncommon since deinstitutionalization beginning in the 1950s, although it still occurs.[3] Community support services including drop-in centers, visits by members of a community mental health team, supported employment[85]
and support groups are common. Some evidence indicates that regular
exercise has a positive effect on the physical and mental health of
those with schizophrenia.[86]

Medication

The first-line psychiatric treatment for schizophrenia is antipsychotic medication,[87]
which can reduce the positive symptoms of psychosis in about 7–14 days.
Antipsychotics, however, fail to significantly ameliorate the negative
symptoms and cognitive dysfunction.[19][88] In those on antipsychotics, continued use decreases the risk of relapse.[89][90] There is little evidence regarding consistent benefits from their use beyond two or three years.[90]

The choice of which antipsychotic to use is based on benefits, risks, and costs.[4] It is debatable whether, as a class, typical or atypical antipsychotics are better.[91][92] Both have equal drop-out and symptom relapse rates when typicals are used at low to moderate dosages.[93]
There is a good response in 40–50%, a partial response in 30–40%, and
treatment resistance (failure of symptoms to respond satisfactorily
after six weeks to two or three different antipsychotics) in 20% of
people.[19]Clozapine is an effective treatment for those who respond poorly to other drugs ("treatment-resistant" or "refractory" schizophrenia),[94] but it has the potentially serious side effect of agranulocytosis (lowered white blood cell count) in less than 4% of people.[4][1][95]

With respect to side effects typical antipsychotics are associated with a higher rate of extrapyramidal side effects while atypicals are associated with considerable weight gain, diabetes and risk of metabolic syndrome.[93] While atypicals have fewer extrapyramidal side effects these differences are modest.[96] It remains unclear whether the newer antipsychotics reduce the chances of developing neuroleptic malignant syndrome, a rare but serious neurological disorder.[97]

For people who are unwilling or unable to take medication regularly, long-acting depot preparations of antipsychotics may be used to achieve control.[98] They reduce the risk of relapse to a greater degree than oral medications.[89] When used in combination with psychosocial interventions they may improve long-term adherence to treatment.[98] The American Psychiatric Association suggests considering stopping antipsychotics in some people if there are no symptoms for more than a year.[90]

Psychosocial

A number of psychosocial interventions may be useful in the treatment of schizophrenia including: family therapy,[99]assertive community treatment, supported employment, cognitive remediation,[100] skills training, token economic interventions, and psychosocial interventions for substance use and weight management.[101]
Family therapy or education, which addresses the whole family system of
an individual, may reduce relapses and hospitalizations.[99]
Evidence for the effectiveness of cognitive-behavioral therapy (CBT) in
either reducing symptoms or preventing relapse is minimal.[102][103] Art or drama therapy have not been well-researched.[104][105]

Prognosis

Schizophrenia has great human and economic costs.[4] It results in a decreased life expectancy by 10–25 years.[106] This is primarily because of its association with obesity, poor diet, sedentary lifestyles, and smoking, with an increased rate of suicide playing a lesser role.[4][106] Antipsychotic medications may also increase the risk.[106] These differences in life expectancy increased between the 1970s and 1990s.[107]
Schizophrenia is a major cause of disability, with active psychosis ranked as the third-most-disabling condition after quadriplegia and dementia and ahead of paraplegia and blindness.[108] Approximately three-fourths of people with schizophrenia have ongoing disability with relapses[19] and 16.7 million people globally are deemed to have moderate or severe disability from the condition.[109] Some people do recover completely and others function well in society.[110] Most people with schizophrenia live independently with community support.[4]
In people with a first episode of psychosis a good long-term outcome
occurs in 42%, an intermediate outcome in 35% and a poor outcome in 27%.[111] Outcomes for schizophrenia appear better in the developing than the developed world.[112] These conclusions, however, have been questioned.[113][114]

There is a higher than average suicide
rate associated with schizophrenia. This has been cited at 10%, but a
more recent analysis revises the estimate to 4.9%, most often occurring
in the period following onset or first hospital admission.[6][115] Several times more (20 to 40%) attempt suicide at least once.[67][116] There are a variety of risk factors, including male gender, depression, and a high intelligence quotient.[116]

Schizophrenia and smoking have shown a strong association in studies world-wide.[117][118]
Use of cigarettes is especially high in individuals diagnosed with
schizophrenia, with estimates ranging from 80 to 90% being regular
smokers, as compared to 20% of the general population.[118] Those who smoke tend to smoke heavily, and additionally smoke cigarettes with high nicotine content.[119]
Some evidence suggests that paranoid schizophrenia may have a better
prospect than other types of schizophrenia for independent living and
occupational functioning.[120]

Epidemiology

Schizophrenia affects around 0.3–0.7% of people at some point in their life,[4] or 24 million people worldwide as of 2011.[121] It occurs 1.4 times more frequently in males than females and typically appears earlier in men[1]—the peak ages of onset are 25 years for males and 27 years for females.[122]Onset in childhood is much rarer,[123] as is onset in middle- or old age.[124] Despite the received wisdom that schizophrenia occurs at similar rates worldwide, its frequency varies across the world,[67][125] within countries,[126] and at the local and neighborhood level.[127] It causes approximately 1% of worldwide disability adjusted life years[1] and resulted in 20,000 deaths in 2010.[128] The rate of schizophrenia varies up to threefold depending on how it is defined.[4]

In 2000, the World Health Organization
found the prevalence and incidence of schizophrenia to be roughly
similar around the world, with age-standardized prevalence per 100,000
ranging from 343 in Africa to 544 in Japan and Oceania for men and from
378 in Africa to 527 in Southeastern Europe for women.[129]

History

In the early 20th century, the psychiatrist Kurt Schneider
listed the forms of psychotic symptoms that he thought distinguished
schizophrenia from other psychotic disorders. These are called first-rank symptoms or Schneider's first-rank symptoms.
They include delusions of being controlled by an external force; the
belief that thoughts are being inserted into or withdrawn from one's
conscious mind; the belief that one's thoughts are being broadcast to
other people; and hearing hallucinatory voices that comment on one's
thoughts or actions or that have a conversation with other hallucinated
voices.[130] Although they have significantly contributed to the current diagnostic criteria, the specificity
of first-rank symptoms has been questioned. A review of the diagnostic
studies conducted between 1970 and 2005 found that they allow neither a
reconfirmation nor a rejection of Schneider's claims, and suggested that
first-rank symptoms should be de-emphasized in future revisions of
diagnostic systems.[131]
The history of schizophrenia is complex and does not lend itself easily to a linear narrative.[132] Accounts of a schizophrenia-like syndrome
are thought to be rare in historical records before the 19th century,
although reports of irrational, unintelligible, or uncontrolled behavior
were common. A detailed case report in 1797 concerning James Tilly Matthews, and accounts by Phillipe Pinel published in 1809, are often regarded as the earliest cases of the illness in the medical and psychiatric literature.[133] The Latinized term dementia praecox was first used by German alienist Heinrich Schule in 1886 and then in 1891 by Arnold Pick in a case report of a psychotic disorder (hebephrenia). In 1893 Emil Kraepelin borrowed the term from Schule and Pick and in 1899 introduced a broad new distinction in the classification of mental disorders between dementia praecox and mood disorder (termed manic depression and including both unipolar and bipolar depression).[134] Kraepelin believed that dementia praecox
was probably caused by a long-term, smouldering systemic or "whole
body" disease process that affected many organs and peripheral nerves in
the body but which affected the brain after puberty in a final decisive
cascade.[135] His use of the term "praecox" distinguished it from other forms of dementia such as Alzheimer's disease which typically occur later in life.[136] It is sometimes argued that the use of the term démence précoce
in 1852 by the French physician Bénédict Morel constitutes the medical
discovery of schizophrenia. However this account ignores the fact that
there is little to connect Morel's descriptive use of the term and the
independent development of the dementia praecox disease concept at the end of the nineteenth-century.[137]

Molecule of chlorpromazine (trade name Thorazine), which revolutionized treatment of schizophrenia in the 1950s

The word schizophrenia—which translates roughly as "splitting of the mind" and comes from the Greek roots schizein (σχίζειν, "to split") and phrēn, phren- (φρήν, φρεν-, "mind")[138]—was coined by Eugen Bleuler in 1908 and was intended to describe the separation of function between personality, thinking, memory, and perception. American and British interpretations of Beuler led to the claim that he described its main symptoms as 4 A's: flattened Affect, Autism, impaired Association of ideas and Ambivalence.[139][140]
Bleuler realized that the illness was not a dementia, as some of his
patients improved rather than deteriorated, and thus proposed the term
schizophrenia instead. Treatment was revolutionized in the mid-1950s
with the development and introduction of chlorpromazine.[141]

In the early 1970s, the diagnostic criteria for schizophrenia were
the subject of a number of controversies which eventually led to the operational criteria
used today. It became clear after the 1971 US-UK Diagnostic Study that
schizophrenia was diagnosed to a far greater extent in America than in
Europe.[142] This was partly due to looser diagnostic criteria in the US, which used the DSM-II manual, contrasting with Europe and its ICD-9. David Rosenhan's 1972 study, published in the journal Science under the title "On being sane in insane places", concluded that the diagnosis of schizophrenia in the US was often subjective and unreliable.[143]
These were some of the factors leading to the revision not only of the
diagnosis of schizophrenia, but the revision of the whole DSM manual,
resulting in the publication of the DSM-III in 1980.[144]
The term schizophrenia is commonly misunderstood to mean that affected
persons have a "split personality". Although some people diagnosed with
schizophrenia may hear voices and may experience the voices as distinct
personalities, schizophrenia does not involve a person changing among
distinct multiple personalities. The confusion arises in part due to the
literal interpretation of Bleuler's term schizophrenia (Bleuler
originally associated Schizophrenia with dissociation and included split
personality in his category of Schizophrenia[145][146]).
Dissociative identity disorder (having a "split personality") was also
often misdiagnosed as Schizophrenia based on the loose criteria in the
DSM-II.[146][147] The first known misuse of the term to mean "split personality" was in an article by the poet T. S. Eliot in 1933.[148] Other scholars have traced earlier roots.[149]

Society and culture

In 2002 the term for schizophrenia in Japan was changed from Seishin-Bunretsu-Byō 精神分裂病 (mind-split-disease) to Tōgō-shitchō-shō 統合失調症 (integration disorder) to reduce stigma.[150] The new name was inspired by the biopsychosocial model; it increased the percentage of patients who were informed of the diagnosis from 37 to 70% over three years.[151] A similar change was made in South Korea in 2012. [152]

In the United States, the cost of schizophrenia—including direct
costs (outpatient, inpatient, drugs, and long-term care) and non-health
care costs (law enforcement, reduced workplace productivity, and
unemployment)—was estimated to be $62.7 billion in 2002.[153] The book and filmA Beautiful Mind chronicles the life of John Forbes Nash, a Nobel Prize-winning mathematician who was diagnosed with schizophrenia.

Violence

Individuals with severe mental illness including schizophrenia are at
a significantly greater risk of being victims of both violent and
non-violent crime.[154] Schizophrenia has been associated with a higher rate of violent acts, although this is primarily due to higher rates of drug use.[155] Rates of homicide linked to psychosis are similar to those linked to substance misuse, and parallel the overall rate in a region.[156]
What role schizophrenia has on violence independent of drug misuse is
controversial, but certain aspects of individual histories or mental
states may be factors.[157]
Media coverage relating to violent acts by individuals with
schizophrenia reinforces public perception of an association between
schizophrenia and violence.[155]
In a large, representative sample from a 1999 study, 12.8% of Americans
believed that individuals with schizophrenia were "very likely" to do
something violent against others, and 48.1% said that they were
"somewhat likely" to. Over 74% said that people with schizophrenia were
either "not very able" or "not able at all" to make decisions concerning
their treatment, and 70.2% said the same of money management decisions.[158]
The perception of individuals with psychosis as violent has more than
doubled in prevalence since the 1950s, according to one meta-analysis.[159]

About Me

My formal training is in chemistry. I also read a great deal of physics and biology. In fact I very much enjoy reading in general, mostly science, but also some fiction and history. I also enjoy computer programming and writing. I like hiking and exploring nature. I also enjoy people; not too much in social settings, but one on one; also, people with interesting or "off-beat" minds draw me to them. I also have some interest in Buddhism.

These days I get a lot more information from the internet, primarily through Wiki. Some television, e. g., documentaries, PBS shows like "Nova" and "Nature".

My favorite science writers are Jacob Bronowski ("The Ascent of Man") and Richard Dawkins (his "The Blind Watchmaker" is right up there up Ascent). I also have a favorite writer on Buddhism, Pema Chodron. Favorite films are "Annie Hall" (by Woody Allen), "The Maltese Falcon", "One Flew Over The Cuckoo's Nest", "As Good As It Gets", "Conspiracy Theory", Monty Python's "Search For The Holy Grail" and "Life of Brian", and a few others which I can't think about at the moment.

I love a number of classical works (Beethoven's "Pastoral", "Afternoon Of A Fawn" and "Clair De Lune" by Debussey , Pachelbel's "Canon" come to mind. My favorite piece is probably Gershwin's "Rhapsody in Blue". But I also enjoy a great deal in modern music, including many jazz pieces, folk songs by people like Dylan, Simon and Garfunkel, a hodgepodge of pieces by Crosby, Stills, and Nash, Niel Young, and practically everything the Beatles wrote.

My life over the last few years has been in some disarray, but I am finally "getting it together.". As I am very much into the sciences and writing, I would like to move more in this direction. I also enjoy teaching. As for my political leanings, most people would probably describe as basically liberal, though not extremely so. My religious leanings are to the absolutely none: I've alluded to my interest in Buddhism, but again this is not any supernatural or scientifically untested aspect of it but in the way it provides a powerful philosophy and set of practical, day to day methods of dealing with myself and the other human beings.